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Pet Care & Health reviews in Riner

  • A
    Mountain View Humane
    They are incredibly reasonably priced and very quick quality service.  I never actually met the vet but the people that work upfront who admit and discharge the animal were very professional, compassionate and efficient.
    - Andrew D.
  • F
    Veterinary Teaching Hospital - Blacksburg
    Dr. Leib was the supervising clinician for Bertram’s postoperative visit at the Veterinary Teaching Hospital on August 1.  I had specifically requested the opportunity to talk with him, but when the resident came back to the exam room after talking with Dr. Leib, she told me that she would have to “borrow” Bertram to take him to the treatment area, because Dr. Leib would not be meeting with me.  She said that “everything has to go through the residents.” While Bertram was in the treatment area, he was given an injection of anti-nausea medication, about which I was not consulted.  I probably would have refused to authorize such an injection if I had been asked, because a similar injection (and most likely the stinging which it can cause) had provoked a panic attack in his regular veterinarian’s office the preceding day, and he was now able to keep down oral medications.  This was particularly inappropriate since I had signed the treatment authorization that day to indicate that it was limited, not comprehensive, and I had pointed that out to the receptionist. The resident, who was just beginning the first year of a three year residency, was clearly in over her head with Bertram’s problem, and she appears to have been given little or no supervision or support.  At the suggestion of Bertram’s regular veterinarian, I had brought up Bertram’s recurrent high fevers at every appointment, including this one.  The resident was unwilling to discuss the fever with me; she was certain that his symptoms were due to inflammatory bowel disease and pancreatitis, and she could offer very little guidance on the chest mass which was found during his pre-surgical cardiac ultrasound.   She sent me home with prednisolone and instructions to take his temperature regularly to monitor the fevers.  He died in the intensive care unit of the Veterinary Teaching Hospital four days later.  An autopsy showed the cause of death to be a ruptured pulmonary abscess. An external review of Bertram’s case was done at my request.  Included as one of its findings is:  “Accepting a diagnosis of mild pancreatitis and inflammatory bowel disease (IBD) for clinical signs that suggested a far more serious illness.  This is a case where clinical signs were forced to fit the pathology findings for the surgical exploratory even though they were incongruous with the severity of the patient’s clinical signs.  We note that the pathologist’s report describes both the pancreatic and jejunal pathology as mild, but future record entries refer only to ‘chronic pancreatitis.’  The inaccuracy is repeated and is eventually accepted as fact.  The PLI elevation was marginal, and PLI, in our experience, is not 100% reliable.  It would appear that no one ever questioned the validity of the diagnosis.  The medicine resident may not have had the experience to recognize this or may not have conveyed all pertinent facts to the senior clinician, Dr. Leib.” I do not hold the resident responsible for Bertram’s death.  He was referred to the Veterinary Teaching Hospital, and especially to Dr. Leib, because his regular veterinarian believed that Bertram’s recurring high fevers did not fit with just bowel disease, and she felt that this aspect of his problem was beyond her understanding or competence.  He needed the breadth and depth of experience of a senior clinician, yet it appears to me that Dr. Leib had minimal involvement in Bertram’s care on this appointment. After Bertram died and I knew from the autopsy that he died of a ruptured pulmonary abscess, not pancreatitis or inflammatory bowel disease, I asked to talk with the director of the Veterinary Teaching Hospital.  When he learned that I wanted an external impartial review, he made the arrangements for one.  As I continued to talk with the hospital director, and as the internal and external review reports became available, it became clear that everyone involved in Bertram’s care had made major mistakes.  Having worked in human medicine for 23 years, I understand that mistakes are inevitable.  While I was not and still am not interested in blame or punishment, I am convinced that it is important that people absorb the lessons of their mistakes to avoid repeating them in the future.  As a result, I asked to meet with Dr. Leib, with just one question on the agenda:  “Knowing what you know now, if you could do it over, what would you do differently?”  He refused to meet with me. I consider the Veterinary Teaching Hospital to be a high risk choice for the care of a very sick animal.  I wish I could say that avoiding Dr. Leib would be sufficient to assure good medical care for your animal.  However, the chief of small animal internal medicine was part of the panel which performed an internal review of Bertram’s case, and he signed a report which included the following statement: “Some aspects of the case reflect systemic failures…The importance of patient care should never be minimized, and we should strive to improve, but some of the documented failings might be inherent in the need to both teach and care for patients.”  This says very clearly, at least to me, that the patient is not the priority, for anyone on the faculty of the Teaching Hospital. I have been insistent that the individuals and the institution acknowledge and take responsibility for their mistakes.  I made it clear from the beginning that I have no intention of pursuing litigation.  The director of the teaching hospital was generous with his time in reviewing what went wrong, but once it became clear that accountability was something which I required, the legal department at Virginia Tech directed that all conversations with me cease.  With reluctance, I filed a complaint with the Board of Veterinary Medicine, and was informed that state employed veterinarians are not licensed and thus not subject to review by the Board.  I was directed to raise the issue with Virginia Tech -- where the legal department had already shut down communication. So, take your animal there if you must, but realize that if something goes wrong, the Teaching Hospital will not deal with you, and the Board of Veterinary Medicine will be unable to investigate your complaint.  For my remaining cat, I have established a relationship with Carolina Veterinary Specialists in Greensboro for anything that his regular vet feels she cannot handle.  I have taken this cat there once, and they were wonderful.  For me it is a two and a half hour drive, but I will make it willingly.
    - Lee H.
  • F
    Veterinary Teaching Hospital - Blacksburg
    Since Bertram had a longstanding heart murmur, his evaluation began with a cardiac ultrasound.  When the intern working under Dr. Miller?s direction talked with me after the cardiac ultrasound, she told me that it had revealed a mass in Bertram?s chest, and wanted to know if I wanted to cancel the planned exploratory surgery as a result.  As we talked through the options, she told me that a CT scan could be done, but the location of the mass meant that it would be difficult to biopsy and dangerous to try to remove.  She did not, nor did Dr. Miller later, tell me that the cardiologist who did the ultrasound had recommended CT, MRI, or thoracic ultrasound for further evaluation; I did not learn that until after Bertram was dead and I asked for a copy of the entire medical record.
    The failure to inform me of the recommendation for further diagnostic evaluation of the chest mass meant that my decision was based on incomplete information.  I decided against any further diagnostic work on the basis of the intern?s assessment, which I assumed was endorsed by Dr. Miller, that it was likely to be pointless.  In retrospect, I should have recognized that the decision to have CT done was independent of the decision about biopsy and/or surgery for the mass.  Possibly if we had done the CT, we would have known earlier what the real problem was, at a point where it was still treatable, and he would be alive today.  In addition, without that information, Bertram was subjected to a major surgical procedure which did him no good, and which made his last days of life more miserable than they needed to be.
    Furthermore, Dr. Miller added a note to the record dated 8/14/2012 (22 days after Bertram?s initial appointment with her, 9 days after his death, and 6 days after my letter complaining about Bertram?s care had arrived at the Veterinary Teaching Hospital) in which she describes in detail a conversation (regarding further evaluation by CT) which did not take place; my detailed discussions of this topic were all with the intern.
    Bertram was sent home after his surgery on 7/24/2012 with no plan for managing his continuing problem with nausea.  This made me uneasy, because he had required a great deal of medication to control his nausea, and there was nothing about exploratory surgery with biopsies that would have dealt with that problem.  In addition, I know that post-operative vomiting is a major concern for humans after abdominal surgery, both for the pain involved and because of the physical damage it can cause.  Both the intern and Miller knew how much medication had been required, because the previous day during his pre-op evaluation, the intern had asked me to leave my notebook with all of Bertram?s records, including his medication log, with her.
    On July 31, seven days after surgery, Bertram experienced two episodes of the most violent vomiting I have ever seen.  Both  obviously caused him great pain, because he kept crying and repositioning himself.  After the first episode of vomiting, I called his regular veterinarian?s office and was told to give him his oral nausea medication.  He could not keep that down, so I was told to bring him to their office for treatment.
    While his regular veterinarian was giving Bertram an injection of anti-nausea medication, he pulled himself away from her with such force that he bent the needle, flipped into the air, crash landed on the floor, and skidded into the trash can in the corner.  We were all astonished at this behavior from a cat who had always been very calm and agreeable.  It took both the tech and myself to hold Bertram so that his vet could give him the injection.  I realized after we got home that he was limping.
    I talked with the intern later that day, and let her know that I thought that the failure to plan for his continuing nausea bordered on negligence.  She quickly said that she would have Dr. Miller call me.  I told Dr. Miller the same thing.  She took absolutely no responsibility for the problem, and expressed no regret for what Bertram had experienced.   A subsequent external review indicated that one of the problems in Bertram?s care was Dr. Miller?s failure to have internal medicine involved for the post-surgical medical management of his symptoms.
    After Bertram died and I knew the cause of death from the autopsy (a ruptured pulmonary abscess, which was the mass visualized on cardiac ultrasound), I realized that the advice that Dr. Miller and the intern gave regarding not doing a CT or other advanced diagnostic study was a mistake.  I have talked with the director of the Veterinary Teaching Hospital several times, and I made it clear from the beginning that I understand that mistakes happen, and that I am not interested in blame or punishment, but that it is important that people absorb the lessons of their mistakes to avoid repeating them in the future.   I asked to meet with Dr. Miller, with just one question on the agenda:  ?Knowing what you know now, if you could do it over, what would you do differently??  She refused to meet with me.
    As anyone reading this review can tell, I have nothing positive to say about Dr. Miller.  Not only did she fail to communicate the recommendation about further diagnostic evaluation of the chest mass, she advised against it.  Her post-surgical management of Bertram?s nausea was inadequate, and her concern for his suffering was non-existent.  And she was so determined to avoid responsibility for any of these problems that she added documentation to the record which is false.
    I wish I could say that avoiding Dr. Miller would be sufficient to assure good surgical care for your animal.  However, the chief of small animal surgery was part of the panel which performed an internal review of Bertram?s case, and he signed a report which included the following statement: ?Some aspects of the case reflect systemic failures?The importance of patient care should never be minimized, and we should strive to improve, but some of the documented failings might be inherent in the need to both teach and care for patients.?  This says very clearly, at least to me, that the patient is not the priority, for anyone on the faculty of the Teaching Hospital.
    I have been insistent that the individuals and the institution acknowledge and take responsibility for their mistakes.  I made it clear from the beginning that I have no intention of pursuing litigation.  The director of the teaching hospital was generous with his time, in reviewing what went wrong, but once it became clear that accountability was something which I required, the legal department at Virginia Tech directed that all conversations with me cease.  With reluctance, I filed a complaint with the Board of Veterinary Medicine, and was informed that state employed veterinarians are not licensed and thus not subject to review by the Board.  I was directed to raise the issue with Virginia Tech -- where the legal department had already shut down communication.
    So, take your animal there if you must, but realize that if something goes wrong, the Teaching Hospital will not deal with you, and the Board of Veterinary Medicine will be unable to investigate your complaint.  For myself and my remaining cat, I have established a relationship with Carolina Veterinary Specialists in Greensboro for anything that his regular vet feels she cannot handle.  I have taken this cat there once, and they were wonderful.  For me it is a two and a half hour drive, but I will make it willingly.
    - Lee H.
  • A
    Riner Animal Hospital
    I don't think any vet is cheap, but I think they are worth the cost. They're very kind to the pet. They're very gentle, thorough, and very competent.
    - Rita K.
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